December 1

Study found: older patients risk death on BOTH old and new Antipsychotics

Study found: older patients risk death on BOTH old and new Antipsychotics

Thu, 01 Dec 2005

Elderly patients prescribed antipsychotics–old neuroleptics (such as Haldol) or the new antipsychotics (such as Zyprexa or Risperdal)–were at increased risk of death.

The risk for the older drugs is estimated to be 17.9%  and the risk of death with the newer drugs is14.6% .

Peter Rabins, a professor of psychiatry at Johns Hopkins School of Medicine, is quoted in The Wall Street Journal, noting that the drugs are overused and “sometimes they are used when nondrug approaches would be likely just as beneficial.”

So what is the justification for using chemical restraints on the elderly?

What has turned us into such a cruel and inhumane society that the elderly can look forward to being zonked with toxic drugs that shorten their lives?

Unless all we care about is the convenience of caregivers and the profit margins of antipsychotic manufacturers!

To whit, the Senate has just bestowed another taxpayer give-a-way to the manufacturers of these drugs.

Contact: Vera Hassner Sharav

Study Warns of Older Antipsychotics

December 1, 2005; Page D7

Older drugs for treating mental disorders carry a higher risk of death among elderly patients than a newer generation of medicines used to treat the conditions, according to a new study that may result in calls for expanded warnings for the older treatments.

The Food and Drug Administration warned this year that elderly patients with mental illness who use an array of newer antipsychotic drugs — including brand names such as Zyprexa and Risperdal — were at greater risk of death than those taking no drugs. But the agency didn’t include in the warning older antipsychotics, including drugs in the phenothiazine and buterophenone class with brand names such as Thorazine and Haldol.

Concerned that doctors may switch their elderly patients to older drugs as a result of the warning, researchers at Brigham and Women’s Hospital in Boston studied the medical records of 22,890 patients in Pennsylvania who were prescribed both older and newer antipsychotics from 1993 to 2004.

The results, published in this week’s New England Journal of Medicine, found that the risk of death was higher with older antipsychotic medications. In the first 40 days after beginning treatment with older drugs, patients had a 56% increase in the risk of death, compared with patients taking newer drugs. Within 180 days, the increase in mortality risk was 37% for the older drugs, according to the study.

Of the 9,142 patients taking the older drugs, 17.9%, or 1,636 patients, died within 180 days of beginning medication. The death rate for the 13,748 patients taking the newer drugs was 14.6%, or 2,007 patients. The rates for increased risk of death were extrapolated from these numbers by adjusting for age and other risk factors among the patients. The researchers estimated that for every 100 patients given the older drugs instead of the newer ones, there would be seven additional deaths.

The causes of death were unavailable, according to the study.

Philip Wang, the study’s lead author, said doctors familiar with the FDA warning might have concluded there was a lack of death risk in using older drugs. “We wanted to see if older drugs shared the same risk. In fact they do, and it looks like there may be even more risk,” he said. The older drugs in the study included 15 different varieties. The newer class included six different drugs.

Antipsychotic medications are frequently prescribed for seniors to treat problems such as agitation, delirium and dementia. A study of Medicare nursing-home patients this year found a quarter of them were on antipsychotic drugs.

Peter Rabins, a professor of psychiatry at Johns Hopkins School of Medicine, said the study results, along with the FDA warning earlier this year on newer drugs, may result in a decline in the number of elderly patients who are prescribed antipsychotic medications. But he added that the drugs are overused and “sometimes they are used when nondrug approaches would be likely just as beneficial.”

When the FDA issued its warning on the new drugs in April, it said it was considering adding a warning label to the older antipsychotic medications. The agency said limited data complicated that decision. An FDA spokeswoman yesterday said the new study isn’t as “clear-cut” as the data used to justify the warning label for new drugs and the agency still “does not have sufficient information at this time to justify a label change” for older drugs. She said the agency continues to study the issue.

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